胎盘生长因子和可溶性 fms 样酪氨酸激酶 1/胎盘生长因子比值在高血压妊娠疾病管理中的临床价值：中国的回顾性真实世界研究。

The clinical value of PlGF and the sFlt1/PlGF ratio in the management of hypertensive pregnancy disorders: A retrospective real-world study in China.

机构信息

Department of Obstetrics, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China; The Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.

Department of Obstetrics, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China; Department of Obstetrics, the First Affiliated Hospital of Jinan University, Guangzhou, China.

出版信息

Clin Chim Acta. 2022 Mar 1;528:90-97. doi: 10.1016/j.cca.2022.01.021. Epub 2022 Jan 29.

DOI:10.1016/j.cca.2022.01.021

PMID:35104464

Abstract

INTRODUCTION

The soluble fms-like tyrosine kinase 1 (sFlt1)/placental growth factor (PlGF) ratio is a useful parameter for the diagnosis of preeclampsia. However, a comprehensive comparison of the ratio in preeclampsia and other hypertensive disorders of pregnancy was still missing and the dynamic levels of PlGF in the process of these diseases needed more clinical evidence.

METHODS

This retrospective study included participants tested for serum sFlt1 and PlGF levels at a national hospital in China throughout 2020. Diagnostic performance of the sFlt1/PlGF ratio and blood pressure was assessed by the receiver operating characteristic (ROC) analysis. The correlation of the sFlt1/PlGF ratio with pregnancy outcomes was evaluated using Kaplan-Meier curves. Besides, the circulating levels of PlGF were monitored in the time course of different hypertensive disorders' progress.

RESULTS

The sFlt1/PlGF ratios were significantly elevated in the women with preeclampsia. The results of ROC analysis showed that, compared with blood pressure, the ratio is reliable for preeclampsia diagnosis from healthy control and shows better performance in distinguishing preeclampsia from other hypertensive disorders of pregnancy. A higher ratio than 85 could be used as an indicator of developing severe preeclampsia with adverse outcomes such as preterm delivery. Besides, our results suggested that using PlGF to predict preeclampsia should after 20 weeks of pregnancy.

CONCLUSION

The PlGF and sFlt1/PlGF ratio are worth implementing in clinical management of women with preeclampsia rather than other hypertensive disorders of pregnancy.

摘要

简介

可溶性 fms 样酪氨酸激酶 1（sFlt1）/胎盘生长因子（PlGF）比值是诊断子痫前期的有用参数。然而，子痫前期和其他妊娠高血压疾病的比值综合比较仍存在空白，这些疾病中 PlGF 的动态水平需要更多的临床证据。

方法

本回顾性研究纳入了 2020 年在中国一家医院检测血清 sFlt1 和 PlGF 水平的参与者。采用受试者工作特征（ROC）分析评估 sFlt1/PlGF 比值和血压的诊断性能。采用 Kaplan-Meier 曲线评估 sFlt1/PlGF 比值与妊娠结局的相关性。此外，还监测了不同高血压疾病进展过程中 PlGF 的循环水平。

结果

子痫前期患者的 sFlt1/PlGF 比值显著升高。ROC 分析结果表明，与血压相比，该比值可用于健康对照人群子痫前期的诊断，并且在区分子痫前期与其他妊娠高血压疾病方面具有更好的性能。比值高于 85 可作为发生不良结局（如早产）的重度子痫前期的指标。此外，我们的研究结果表明，应在妊娠 20 周后使用 PlGF 预测子痫前期。